EMT - Chapter 24: Trauma Overview

Signs of a pulmonary blast injury include: A. vomiting blood. B. coughing up blood. C. an irregular pulse. D. multiple rib fractures.

B. coughing up blood.

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A. collapsed dashboard B. deformed steering wheel C. caved-in passenger door D. intrathoracic hemorrhage

B. deformed steering wheel

A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A. lateral impact to the spine B. energy transmission to the spine C. direct trauma to the spinal column D. secondary fall after the initial impact

B. energy transmission to the spine

In contrast to a Level III trauma center, a Level I trauma center must: A. be involved in trauma prevention programs. B. have general surgeons that are in-house 24 hours a day. C. have access to an emergency physician within 30 minutes. D. be able to stabilize patients before transferring to a higher level facility.

B. have general surgeons that are in-house 24 hours a day.

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 7. B. 8. C. 9. D. 10.

A. 7.

The energy of a moving object is called: A. latent energy. B. kinetic energy. C. potential energy. D. converted energy.

B. kinetic energy.

Approximately 25% of severe injuries to the aorta occur during: A. frontal collisions. B. lateral collisions. C. rollover collisions. D. rear-end collisions.

B. lateral collisions.

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion. B. mechanism of injury. C. kinetic energy. D. potential energy.

B. mechanism of injury.

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma. B. neck and facial injuries. C. blunt trauma to the head. D. lower extremity fractures.

B. neck and facial injuries.

A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: A. injury to the cervical spine. B. potential airway compromise. C. damage to internal structures. D. alterations in his mental status.

B. potential airway compromise.

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. will most likely be thrown over the steering column. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. is thrust under the steering column onto the floorboard.

B. remains in motion until acted upon by an external force.

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. realize that the air bag malfunctioned at the time of impact. B. remember that it could still deploy and seriously injure you. C. suspect that the patient may have experienced serious injuries. D. recognize that the force of impact was most likely not severe.

B. remember that it could still deploy and seriously injure you.

A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A. compression of the head against the roof B. lateral bending of the neck during the crash C. impact of the head against the steering wheel D. whiplash injury to the neck during the rollover

A. compression of the head against the roof

When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A. door B. dashboard C. windshield D. steering wheel

A. door

During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the tertiary phase. B. during the secondary phase. C. during the primary phase. D. as a direct result of the pressure wave.

A. during the tertiary phase.

Two of the MOST common mechanisms of injury for blunt trauma are: A. falls and motor vehicle collisions. B. low-caliber gunshot wounds and falls. C. gunshot wounds and vehicle ejections. D. motor vehicle collisions and stabbings.

A. falls and motor vehicle collisions.

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience? A. head injury B. cardiac contusion C. pulmonary contusion D. multiple rib fractures

A. head injury

The cervical spine is MOST protected from whiplash-type injuries when the: A. headrest is appropriately positioned. B. air bag correctly deploys upon impact. C. patient tenses up at the time of impact. D. rear end of the vehicle is initially struck.

A. headrest is appropriately positioned.

When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall. B. any fall in the elderly is considered to be high-energy trauma. C. elderly patients who fall usually have a secondary head injury. D. bilateral hip fractures usually occur when an elderly person falls.

A. osteoporosis can cause a fracture that may have resulted in the fall.

A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. stabilize her entire spine. B. obtain baseline vital signs. C. inspect the helmet for cracks. D. leave her bicycle helmet on.

A. stabilize her entire spine.

If one or more occupants in the same vehicle are killed in a crash, the EMT should: A. suspect that all living occupants experienced the same serious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. rapidly assess only the survivors who have experienced obvious trauma.

A. suspect that all living occupants experienced the same serious trauma.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. the speed of the fall. B. the surface struck. C. the height of the fall. D. the primary impact point.

A. the speed of the fall.

According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. D. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.

A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.

The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: A. transport to a trauma center. B. a focused exam of her forearm. C. transport to a community hospital. D. a secondary assessment at the scene.

A. transport to a trauma center.

Force acting over a distance defines the concept of: A. work. B. latent energy. C. kinetic energy. D. potential energy.

A. work.

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8. B. 9. C. 10. D. 11.

B. 9.

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. flail chest B. aortic rupture C. extremity fractures D. forehead lacerations

B. aortic rupture

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was propelled away from the vehicle. B. approximate the speed of the vehicle that struck the pedestrian. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle.

B. approximate the speed of the vehicle that struck the pedestrian.

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. capitation. B. cavitation. C. congruent. D. conversion.

B. cavitation.

With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A. It provides the least amount of information about the mechanism of injury. B. It has a direct effect on patient care because of the obvious vehicular damage. C. It is the most dramatic part of the collision and may make extrication difficult. D. It occurs when the unrestrained occupant collides with the interior of the vehicle.

C. It is the most dramatic part of the collision and may make extrication difficult.

Which of the following patients has experienced the MOST significant fall? A. a 4′8″ patient who fell 13′ B. a 5′0″ patient who fell 13′ C. a 4′6″ patient who fell 13′ D. a 5′9″ patient who fell 14′

C. a 4′6″ patient who fell 13′

When treating a patient who experienced a pulmonary blast injury, you should: A. use a demand valve to ventilate the patient. B. suspect an accompanying cardiac tamponade. C. avoid giving oxygen under positive pressure. D. administer large amounts of intravenous fluid.

C. avoid giving oxygen under positive pressure.

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. underlying cardiac disease. B. a lacerated coronary artery. C. bruising of the heart muscle. D. traumatic rupture of the aorta.

C. bruising of the heart muscle.

Air bags are designed to: A. prevent a second collision inside the car. B. be used with or without a shoulder harness. C. decrease the severity of deceleration injuries. D. prevent the driver from sustaining head trauma.

C. decrease the severity of deceleration injuries.

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. spinal cord injury. B. airway compromise. C. intracranial bleeding. D. a fracture of the skull.

C. intracranial bleeding.

When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. triples. C. quadruples. D. is not affected.

C. quadruples.

If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? A. severe burns B. fractured bones C. stomach rupture D. impaled objects

C. stomach rupture

Internal injuries caused by gunshot wounds are difficult to predict because: A. the caliber of the bullet is frequently unknown. B. the area of damage is usually smaller than the bullet. C. the bullet may tumble or ricochet within the body. D. exit wounds caused by the bullet are usually small.

C. the bullet may tumble or ricochet within the body.

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. thoracic and sacral spine. B. lumbar and coccygeal spine. C. thoracic and lumbar spine. D. lumbar and sacral spine.

C. thoracic and lumbar spine.

The index of suspicion is MOST accurately defined as: A. the way in which traumatic injuries occur. B. a predictable pattern that leads to serious injuries. C. your concern for potentially serious underlying injuries. D. the detection of less obvious life-threatening injuries.

C. your concern for potentially serious underlying injuries.

By what mechanism is a person injured when he or she falls from a significant height? A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. B. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

Which of the following statements regarding low-energy penetrating injuries is correct? A. Internal injuries caused by low-velocity bullets are usually easy to predict. B. Exit wounds are typically easy to locate with low-energy penetrating injuries. C. It is usually easy to differentiate between an entrance wound and an exit wound. D. The area of injury is usually close to the path the object took through the body.

D. The area of injury is usually close to the path the object took through the body.

Which of the following statements regarding gunshot wounds is correct? A. High-velocity bullets will cause less severe internal injuries. B. The size of a bullet has the greatest impact on producing injury. C. Low-velocity bullets will cause the greatest amount of trauma. D. The speed of a bullet has the greatest impact on producing injury.

D. The speed of a bullet has the greatest impact on producing injury.

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. apply a cervical collar. B. obtain baseline vital signs. C. auscultate bowel sounds. D. assess for an exit wound.

D. assess for an exit wound.

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. dismounted seats B. steering wheel deformity C. intrusion into the vehicle D. deployment of the air bag

D. deployment of the air bag

According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. B. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact. B. assess the severity of the third collision of the crash. C. recognize if the driver hit the brakes before impact. D. identify contact points and predict potential injuries.

D. identify contact points and predict potential injuries.

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. is wearing only a lap belt. B. remains within the vehicle. C. experiences multiple impacts. D. is ejected or partially ejected.

D. is ejected or partially ejected.

When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious. B. primary blast injuries are typically the most obvious. C. solid organs usually rupture from the pressure wave. D. primary blast injuries are the most easily overlooked.

D. primary blast injuries are the most easily overlooked.

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. intravenous fluid administration B. early administration of oxygen C. elevation of the lower extremities D. rapid transport to a trauma center

D. rapid transport to a trauma center

What types of motor vehicle collisions present the greatest potential for multiple impacts? A. lateral and rollover B. frontal and rotational C. Rear-end and rotational D. rotational and rollover

D. rotational and rollover